PROTOCOL: The effectiveness of social protection interventions in low‐ and middle‐income countries: An evidence and gap map

Abstract This evidence and gap map will provide an overview of the existing systematic reviews and impact evaluations on the key outcome domains and interventions aimed at improving social protection among people living in low‐ and middle‐income countries (LMICs). The specific objectives of this map are to: (1) Develop a clear framework of types of interventions and outcomes related to the effectiveness of interventions on social protection for people in LMICs. (2) Map available systematic reviews and primary studies on the effectiveness of interventions on social protection for people in LMICs. (3) Provide a structured and accessible collection of existing evidence and identifying gaps in the available evidence on social protection intervention, thereby helping to inform the research agendas of funders and other organisations.

Social protection is broader than social security which includes social services, protection against financial insecurity and social welfare. Social protection is designed to accommodate the assistance for catastrophes of life in partnership with the public and private sectors, signifying better outcomes. Its purpose is to increase the capacity to meet the needs of the people and promote human welfare (Mpedi, 2011).
Many countries have not improved their investment towards social protection. It is possible to gradually build social protection and, relying on comprehensive long-term national social protection action plans. These action plans are expanding the social insurance schemes now in operation; building community or employment-based insurance schemes on a voluntary basis, introducing and extending social welfare services, employment guarantee schemes and public finance and non-contributory cash transfers (African union, 2008).
The map will cover a broad range of intervention for social protection among children, adults and geriatric populations focusing on low-and middle-income countries (LMICs).
LMICs are defined by World Bank as low-income economiesthose with a Gross National Income (GNI) <$995; lower middleincome economies-those with a GNI per capita between $996 and $3895; and upper middle-income economies-those with a GNI per capita between $3896 and $12,055 (The World Bank, 2018). People living in LMICs experience many forms of insecurity and is a hard truth for the poorest of the poor in the informal economy. They are most in need of support and protection, yet they are the ones who are least protected, since we are far from realising that social protection is a right for all (García & Gruat, 2003).
The World Bank estimates that more than 1 billion people in developing countries participate in at least one social assistance programme (Gentilini et al., 2014). The ILO estimates that only 27% of the world's population has access to comprehensive social security systems (ILO, 2014). There is wide variation in coverage, with most programmes only reaching the middle poor and middle-income countries, not the extreme poor (Gentilini et al., 2014). In recent years, the success of social protection interventions in middle income countries (MICs) such as Brazil and Mexico, along with the series of food, fuel, and financial crises, has prompted policymakers in low income countries and fragile situations to examine the possibility of introducing such programmes in their own countries (Andrews et al., 2012).
It is also essential to note that if social protection can improve the sustainable development goals (SDGs) of WHO, then the key global objectives should be poverty reduction and sustainable development. The World Bank Group supports universal access to social protection, and is central to its goals of ending poverty and boosting shared prosperity. Universal social protection coverage includes: providing social assistance through cash transfers to those who need them, especially children; benefits and support for people of working age in case of maternity, disability, work injury or for those without jobs; and pension coverage for the elderly.
Assistance is provided through social insurance, tax-funded social benefits, social assistance services, public works programmes and other schemes guaranteeing basic income security (The World Bank, 2019).
Although social protection can be a successful tool to lift people out of poverty, a special focus on the poorest of the households is necessary to increase their participation and benefits from the interventions (Kestere Van Kesteren et al., 2018).
Also, to accelerate progress on social protection, it requires governments and development partners to have the best available data on what works best and where the gaps are in implementing social protection measures, it becomes essential to have an interactive evidence and gap map (EGM) on effectiveness of social protection measures in LMICs.
EGM provide a visual overview of the availability of evidence for a particular sector. In this EGM, we will include people in LMICs benefiting from social protection interventions. The EGM will consolidate what we know and do not know about "what works" by mapping out existing and ongoing systematic reviews and impact evaluations in this field; and by providing a graphical display of areas with strong, weak or nonexistent evidence on the effect of interventions or initiatives.

| Scope of the EGM
The EGM will include randomised controlled trials (RCTs), non-RCTs and systematic reviews of effects of interventions. The map will be presented in two dimensions: the rows will list interventions and subcategories, and the columns will include the outcome domains.
Each cell will include studies which contain evidence on the combination of intervention and outcome. Included studies will be coded for additional characteristics tas filters, such as population subgroup, context, country and region. The One-UN Social Protection Floor initiative (SPF-I), currently co-led by the ILO and the World Health Organization (WHO) and endorsed by the UN Chief Executives Board, calls for an integrated set of social policies to provide income security and access to essential social services for all, paying particular attention to vulnerable groups. The core elements of the SPF-I are: a basic set of social transfers, in cash and in kind, to provide a minimum income and/or employment and livelihood security for the unemployed and working poor the universal access to essential social services in the areas of health, water and sanitation, education, food security, housing and others defined by national priorities (ILO, 2005(ILO, , 2011a(ILO, , 2011b. As per Devereux and Sabates-Wheeler (2004), in order to achieve SDGs, the first policy action SDG 1.3 is to "implement nationally appropriate social protection systems and measures for all and by 2030 to achieve substantial coverage of the poor and vulnerable".
An important task is also to customise interventions to the beneficiaries at the individual, family and community levels. The timing and types of social protection interventions should be geared to meeting the specific needs and vulnerabilities especially with regard to protecting individuals, families and communities against health shocks or promoting livelihood ladders so that the SDGs are attained. If the SDGs that include social inclusion and gender equity, nutrition, employment, education, health and economic goals are to become a reality, social protection for all men and women and their families must be a key global objective. At the same time, for social protection to play an effective role in sustainable development its scope must be expanded to meet new global needs and to render it more effective and relevant to the world's entire population.
Social protection measures may have a potential to directly improve the well-being of the individuals, families and thereby the community at large. Socioeconomic security is key to the well-being of the individual and the families in the community. By responding to people's needs, social protection fosters social inclusion, gender equity and helps to build secure communities and stable societies thereby contributing to improvement in the SDGs.
Social protection has a strong focus on SDG outcomes like eradication of poverty and provision of food security. Social protections are important to end poverty and hunger as well as provide for food security in people both in developed and developing countries. In developing countries, the main emphasis of social protection is on addressing the causes of poverty, and not simply its symptoms, F I G U R E 1 Conceptual framework on the effectiveness of social protection interventions in low-and middle-income countries: an evidence and gap map THIMMAPPA ET AL.

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whereas in the developed countries the emphasis of social protection is on income maintenance and on protecting living standards for all (but especially workers). Social protection measures also ensure availability, sustainable management of water, sanitation, and they emphasise on ensuring that affordable, clean energy is available.

| Why it is important to develop the EGM
In response to above, there is an increased need for investment in generation of sound evidence on effective strategies for social protection to strengthen the policy architecture in this area. However, there are still many gaps in the evidence base from these programmes, including geographical gaps, thematic gaps and missing information that constrain the building of a concerted evidence-informed policy and investment agenda.
EGMs can contribute by providing an overview of available quality studies, identifying gaps and thereby aiding the prioritisation of global evidence synthesis needs and impact evaluations. The knowledge generated by the EGM will have the potential to support the identification of areas with potentially sufficient studies to conduct systematic reviews, and assist funders and policymakers to inform funding and/or policy decisions related to the social protection in LMICs. These can be decisions about the selection of potentially effective interventions or the funding of research-for example, research that can fill existing gaps in the knowledge base. This knowledge can facilitate the development of research agendas and priorities.

| Existing EGMs and/or relevant systematic reviews
There is no EGM specifically on social protection interventions in LMICs. However, an EGM titled, "Productive Safety Nets Gap Map" is available in 3ie (https://gapmaps.3ieimpact.org/evidence-maps/ productive-safety-nets-gap-map-all-populations). The EGM provides the evidence on the effects of productive social safety net programmes on poverty and related outcomes. Our EGM focuses on social protection interventions using a broader approach.
There are a number of related systematic reviews available and some are listed below: Systematic Reviews: 1. Interventions to improve the labour market for adults living with physical and/or sensory disabilities in LMICs: A systematic review

| Defining EGMs
Mapping the evidence in an existing area is a relatively new approach that has been used since the early 2000s (Saran & White, 2018).
EGMs are "evidence collections" (Snilstveit et al., 2013, p. 3) that provide a visual overview of the availability of evidence for a particular sector. They help to consolidate what we know and what we do not know about studies that evaluate the effectiveness of interventions in a given area-by mapping out existing and ongoing systematic reviews and impact evaluations in this field, and by providing Autonomous health communities, unemployment insurance and unemployment assistance a graphical display of areas with strong, weak or non-existent evidence on the effect of such interventions.
Studies included in an EGM are identified through a comprehensive search of published and unpublished literature, which targets both completed and ongoing studies-the latter to help identify research in development, which might help fill existing evidence gaps.
The methods for conducting EGMs drawn on the principles and methodologies adopted in existing evidence mapping and synthesis products.

| Framework development and scope
The EGM framework will inform the inclusion and exclusion criteria of the EGM. Here, we describe the population, intervention, comparison, outcomes (indicators) and study designs for the map Table 1.

Population
The key population of interest for this map is all the people living in LMICs.
LMICs are defined by World Bank as low-income economiesthose with a GNI <$995; lower middle-income economies-those with a GNI per capita between $996 and $3895; and upper middle-income economies-those with a GNI per capita between $3896 and $12,055 (2018). Both males and females in all the age group will be included in the EGM. The age group will be classified based on the WHO age criteria; infanthood (<3 years of age), childhood (3-11 years), adolescence (12-18 years), adults (19-59 years), elderly (61-80 years) and oldest (80+ years). Population subgroup of interest includes: vulnerable children (e.g., child labourers, orphans), men, women, ethnic minorities, conflict-affected, people living with disabilities, the displaced, migrants, refuges and the unemployed.

Intervention
The intervention categories framework is based on the World Bank's Group 10-year social protection and labour strategy (2012-2022). It identifies three evidence-based strategies to improve social protection: social assistance, social insurance and labour marketing. Table 1  The intervention categories included in our map are: 1. Social assistance: noncontributory transfers in cash, vouchers, or inkind (including school feeding) to individuals or households in need, public works programmes; fee waivers (for basic health and education services); and subsidies (e.g., for food, fuel) (White, 2016) 2. Social insurance: contributory schemes providing compensatory support in the event of contingencies such as illness, injury, disability, death of a spouse or parent, maternity/paternity, unemployment, old age, and shocks affecting livestock/crops (White, 2016).
3. Labour marketing: active (promoting labour market participation) or passive (ensuring minimum employment standards) (White, 2016) 4. The social protection may include multiple interventions.

Outcome
The seventeen main outcome categories are listed in the Table 2 given below Employment is one of the means to lead a satisfying life in any country. The 10th goal of UNPD is "reduced inequality" (SDG 10) concentrates on decent job creation, entrepreneurship, creativity and innovation, and encourage the formalisation and growth of micro-, small-

| Stakeholder engagement
We will engage stakeholders on the evidence matrix at various organisations who provide Social protection sector policy and programmes. The framework will be informed by theory of change, relevant academic literature and consultations with key stakeholder, including research funders, implementing agencies, experts and researchers.

| Screening and study selection
Types of study designs Systematic reviews and impact evaluation or studies of effectiveness will be included for the EGM.
Definition of systematic reviews: According to the PRISMA definition for SRs (Moher et al., 2015) where the article explicitly states the methods used to identify studies (i.e. a search strategy), strategies for study selection (e.g., eligibility criteria and selection process) and explicitly detail methods of synthesis.
Impact evaluations are defined as intervention evaluations or field experiments that use quantitative approaches applied to experimental or observational data to measure the effect of an intervention relative to a counterfactual representing what would have happened to the same group in absence of that intervention (Khandker et al., 2009). Impact evaluations may also test different intervention designs. Specifically, we will include: 1. Studies where participants are randomly assigned to treatment and comparison group.

Studies where assignment to treatment and comparison group is
based on other known allocation rules, including a threshold on a continuous variable (regression discontinuity designs). We will include: regression discontinuity designs, fixed effect estimation, instrumental variable, propensity score matching and difference-indifference.
3. Since we anticipate a dearth of evidence in this sector from LMICs we will also include Before-versus-after studies with no comparison group.

Treatment of qualitative research
We do not plan to include qualitative research in the EGM.

| Types of settings
All types of settings in the LMICs (The World Bank, 2018) where interventions for social protection were implemented, will be included in the EGM. Examples of the types of settings will include village, town, district, state, urban, semiurban, rural, family, school, refugee camps, old age homes, country at large or a particular geographical or political locations, and so forth.

| Status of Studies
Relevant completed or ongoing studies will be included in the EGM.
The detailed eligibility criteria is given in Appendix C.

| Search strategy and status of studies
The search for included studies will be conducted in three stages:

Stage
Step Timeline

Stage 1 Few of the included studies were pilot screened and coded
April 2019 Stage 2 We search of relevant systematic reviews and primary studies from appropriate databases and international organisations

March 2021
Stage 3 This stage will include search on additional websites for grey literature after expert consultation (in progress)

May 2021
The search will be as comprehensive as possible, using (but not limited to) relevant bibliographic databases, web-based search engines, websites of specialist organisations, bibliographies of relevant reviews, and targeted calls for evidence using professional networks or public calls for submission of articles.

Additionally, citation searches of included studies in Google
Scholar, Scopus and Web of science will be performed. Reference lists of the included reviews will be reviewed (Appendix B).

| Screening and selection of studies
All titles and abstracts, and then full text, will be double screened. A third reviewer will help to resolve in the event of disagreement. The screening tool is given as Appendix D.

| Data extraction, coding and management
Coding will be done independently by two coders, with a third-party arbitrator or in the event of disagreement.

| Data extraction and management
State how data will be extracted from reports of included studies, clarifying how many people will be involved (and whether independently), whether machine learning will be used (and if so, how) and how disagreements will be handled (ER34). Campbell reviews usually use two independent reviewers to screen for inclusion. However, there is increasing use of automation. Any use of automation and text-mining should be described in sufficient detail for replication and with information about validity and testing of the method.
List the types of information that will be sought from reports of included studies (ER36). Describe any attempts to obtain or clarify data from individuals or organisations, if applicable (ER35).
Describe what coding categories will be used, how they will be collected and by whom. Coding sheets should be pretested and included as an annex in the protocol.

| Quality appraisal
The quality of the included systematic reviews will be assessed using AMSTAR 2 and done independently by two reviewers. The quality review of the primary studies will be rated based on the quality assessment tool for individual studies as described below.
The tool used to assess study quality is shown in Appendix E. This tool includes six criteria that are appropriate for the assessment of quantitative impact evaluations. These are as follows: 1. Study design (potential confounders taken into account): impact evaluations need either a well-designed control group (preferably based on random assignment) or an estimation technique which controls for confounding and the associated possibility of selection bias. low if the outcome is named but not adequately described.
6. Baseline balance: Baseline balance means that the treatment and comparison groups have the same average characteristics at baseline, not only for outcomes but other factors which may affect the impact of the programme.
Overall assessment: The overall assessment uses a weakest link in the chain principle so that the overall assessment is the lowest of assessment given to any of the relevant items. As mentioned above, not all items are used in this assessment. So the overall assessment is the lowest of the assessments for items 1, 4, 6 and 7.

| Planned analysis
The EGM report shall provide tabulations or graphs of the number of studies, with accompanying narrative description, by • Intervention category and subcategory • Outcome domain and subdomain •

| Unit of analyses
Each entry in the map will be a systematic review or a primary study of effectiveness. The final EGM will identify the number of studies covered by the map in each sector or subsector.

| Presentation
In addition to the interventions and outcomes, the following filters will be coded: 1.

CONTRIBUTIONS OF AUTHORS
Please note that this is the recommended optimal EGM team composition.

• Content
Dr Latha holds PhD in Medical surgical nursing and has been extensively involved in areas of oncology, nursing Education and Research. She also published various research articles on nursing and medical research.
• EGM methods Ashrita Saran has previous experience in systematic review methodology, including searching, data collection, and theory-based synthesis, which means she is proficient in carrying out the various processes in an EGM, such as search, eligibility screening, quality assessment and coding. She has undertaken an overview of approaches to mapping in a range of organisations. All the authors have previous experience of working on various stages of systematic reviews as screening, coding, drafting search strategy.
• Information retrieval Ashrita Saran and Latha are trained in designing and implementing search strategies.
All the authors have previous experience of drafting search strategy and have performed systematic review searches.

Declarations of interest
No conflict of interest.

Plans for updating the EGM
Once completed, the EGM will be updated every three years. The lead author and/or the corresponding authors will be responsible for updating the EGM.

Differences between protocol and review
Explain and justify any changes from the protocol (including any post hoc decisions about eligibility criteria (ER59).  • "A pension is an annuity or other periodical payment made, especially by a government, a company, or an employer of labour, in consideration of past services or of the relinquishment of rights, claims, or emoluments".
• "Pensions are universally construed as a reward for long-continued service paid upon retirement from service, and all pensions of public employees are paid upon their retirement".
• "A pension is a stated allowance or stipend made in consideration of past services or of surrender of rights or emoluments to one retired from service" http://www.duhaime.org/LegalDictionary/P/  The ILO approach to unemployment protection covers: (International Labour Organization, 2017). Unemployment protection: A good practices guide and training package. ILO Regional Office for Asia and the Pacific).
comprehensive social protection, to provide income security or income replacement; • Periodical and predictable benefits   Purely qualitative studies will be excluded regardless of design. Descriptive studies (cross-sectional studies) reporting data narratively, but do not give statistical analysis Literature reviews

Population
We will include all the people living in LIMCs including Infanthood, Childhood, Adolescence, Adults, elderly, boys/men, girls/women, pregnant women/girls, children with disability, children in low income settings, ethnic minorities, vulnerable children (e.g., child laborers, orphans), ethnic minorities, conflict-affected, people living with disabilities, the displaced, migrants, refuges and the unemployed We will include multi-centric studies provided the interventions are directed towards people of LMICs and a clear methodology is available. For systematic reviews with global focus, we will: Exclude the Systematic reviews that include studies only from High income even if they did not have any search restrictions Mixed population from high, low-middle and low income countries

Interventions
We will include studies with interventions that aim in improving social protection as a primary focus.
Interventions that focus on psychological wellbeing and human rights will be excluded APPENDIX D: SCREENING TOOL F I G U R E 2 Screening tool for the effectiveness of social protection interventions in low-and middle-income countries: an evidence and gap map regressions (l) Natural experiments (m) Analytical observational (n) Before-after studies (o) Time-series Population People living in LMICs will be included. Population sub groups are: The age group is classified based on the WHO age criteria stated as follows: Infanthood (<3 years of age), Childhood (3-11 years), Adolescence (11-18 years), Adults (18-60 years), elderly (above 60 years), boys/ men, girls/women, pregnant women/girls, children with disability, children in low income settings, ethnic minorities.
People living in high-income countries.

Interventions
The International Labour Organization (ILO) has defined social protection intervention as social assistance, social insurance and labour marketing facilities (ILO, 2014).
Interventions not focused on social protection. We will also exclude studies that deals general interventions which are applicable to all the people such as compulsory immunisation, minimum age for marriage etc.
1. Social assistance (social safety nets) interventions are social/cash transfer/in-kind transfers, child welfare programs and targeted food assistance 2. Social insurance intervention includes pensions (old age/ disability), health insurance, unemployment insurance, disability insurance, maternity benefits, and provident funds 3. Intervention related to labour marketing and active labour market (job centers, job training, policies to promote small and medium sized enterprises) and passive labour market (maternity benefits, injury compensation, sickness benefits, minimum wage)

Outcome
The outcome are social inclusion and gender equity, nutrition, employment, education, health and nutrition and economic status None

Confidence in study findings
Low and medium confidence reviews High confidence reviews Low and medium confidence impact evaluations High confidence impact evaluations